AMS 800 (R) sphincter implantation in children

Purpose: Implantation of urinary sphincter systems in children is seldom in dicated. The primary indication is neurogenic bladder, and in some cases, c ongenital anomalies. We analyzed the postoperative results after implantati on of the AMS 800(R) artificial urinary sphincter in a consecutive series o f children with severe incontinence. Materials and Methods: We performed 15 sphincter implantations in children aged 8-17 years with urinary incontinence; 12 due to neurogenic causes and 3 with bladder exstrophy or epispadias. Results: There were 28 complications in the 15 patients; in 7 a reoperation was necessary. Serious complications requiring removal of the system inclu ded 2 with cuff decubitus and one with scrotal infection. One of these unde rwent subsequent successful reimplantation. Despite relatively frequent pro blems with postoperative activation of the system. 12 patients reported cli nical improvement with urinary continence confirmed by urodynamic testing. Conclusion: Those children who underwent successful implantation of a urina ry sphincter system (12 of 15 in this consecutive series) reported signific ant improvement in quality of life with urodynamic confirmation of urinary continence.